Epilepsy in pregnancy - a collaborative team effort of obstetricians, neurologists and primary care physicians for a successful outcome.

BACKGROUND: Epilepsy is the most commonly encountered serious neurological problem in obstetrical practice. The disease and treating medications may have significant impact on contraceptive choice, efficacy and reproduction. OBJECTIVE: This article seeks to inform general practitioners (GPs) about current developments in the field of pregnancy care for women with epilepsy and to foster a collaborative approach in their management. DISCUSSION: The care of a pregnant woman with epilepsy needs to start well before pregnancy occurs, while she is still under the care of a GP, especially if she is on antiepileptic medication. GPs are familiar with the concept of GP management plans and team care arrangements for chronic diseases. This model of team care should be extended to the management of women with epilepsy with regards to reproduction. It is hoped this will enhance perinatal outcomes for women and their infants by encouraging shared communication between the obstetrician, neurologist and GP.

Pharmacokinetics of a multipurpose pod-intravaginal ring simultaneously delivering five drugs in an ovine model.

Multipurpose technologies that simultaneously protect from sexually transmitted infections and unintended pregnancy are urgently needed. Pod-intravaginal rings (IVRs) formulated with the antiretroviral agents (ARVs) tenofovir, nevirapine, and saquinavir and the contraceptives etonogestrel and estradiol were evaluated in sheep. Steady-state concentrations were maintained for 28 days with controlled, sustained delivery. This proof-of-principle study demonstrates that pod IVRs can deliver three ARVs from different mechanistic classes and a progestin-estrogen combination over the wide range needed for putative preventative efficacy.